Applied Micro

Abstract:

Peru is a developing country that has significantly improved the average of almost all health indicators. Specifically, in the past four decades, child mortality decreased tenfold. However, the same is not necessarily true of equality, which remains a challenge. Using microdata from Peru's population censuses in 1981, 1993, 2007, and 2017, we estimate the inequality in child mortality across different social groups. We estimate differences between ethnic groups, education levels, wealth quintiles, regions, and urban-rural groups and find that although inequality has decreased, it remains significantly high. The data show that inequality in child mortality increased between 1981 and 1993, declined between 1993 and 2007, and then increased between 2007 and 2017. Differences in education are the most crucial factor, associated with 45% of the inequality in 1981 and 58% in 2017. Differences between Lima and rural areas account for 27% to 30% of the inequality, while ethnicity contributes only 6% in 1981 and 10% in 2017.

Abstract:
Adolescent motherhood in Peru has declined over the past four decades; however, pronounced socioeconomic disparities persist. Drawing on microdata from the 1981, 1993, 2007, and 2017 population censuses—which contain sample sizes more than two orders of magnitude larger than those of Demographic and Health Surveys (DHS)—this study examines the long-run evolution of inequalities in adolescent motherhood. We employ relative risk measures, concentration indices, and their decompositions. We also apply a descriptive intercategorical approach that identifies small, multiply disadvantaged groups, a methodology feasible only with large amounts of data,  such as census microdata. National prevalence decreased from 15.4% in 1993 to 11.5% in 2017; nonetheless, the risk ratio between adolescents in the poorest and richest wealth quintiles remained strikingly high. The concentration index (CI) declined between 1981 and 2007; however, this trend reversed after 2007.

Decomposition analysis shows that between 1981 and 2007, the main factor statistically contributing to inequality was education level, accounting for approximately one-third of the total CI. Finally, the intercategorical mapping reveals that in 2017, three groups jointly defined by wealth, education, ethnicity, region, and rurality continued to face adolescent motherhood rates of 43%, levels that have remained virtually unchanged since 1993.

Abstract:
Following the Bicentennial of the republic, there are still no estimates of child mortality for the various Indigenous peoples of the Peruvian Amazon, who represent 1% of the national population and 4% of the total indigenous population. This basic health indicator has previously been calculated using the Demographic and Health Survey at the national level and across different socioeconomic groups. However, the sample size of this survey limits the reliability of estimates for the different Amazonian Indigenous peoples. Using individual-level data from mothers registered in the national censuses, we can provide the first estimate of child mortality among Indigenous peoples in the Peruvian Amazon. Our findings reveal significant inequity affecting Amazonian Indigenous peoples, with a child mortality rate of three times higher than in Lima and 70% higher than that of other residents of the Amazon. Rural Shipibo-Konibo children face a double mortality rate compared to Awajún children. Although higher maternal education and greater household wealth are associated with lower mortality rates among Amazonian Indigenous children, significant disparities persist when these children are compared with those from other ethnic groups with similar levels of mothers' education and wealth. Even after accounting for socioeconomic factors, mortality among Amazonian Indigenous children remains disproportionately high, a result that is robust to both linear and count-data regression models.